Menopause and sleep problems

By Dr Simon Kyle

The menopausal transition is characterized by considerable hormonal changes, most notably, reductions in the level of the hormone 'oestradiol' and increases in follicle stimulating hormones (FSH). During this period the majority of women experience symptoms such as hot flashes and night-sweats as well as changes in mood. Reports of difficulty falling asleep and staying asleep tend to increase during the menopause transition; and hot-flash frequency is associated with reports of poor sleep quality.

A recent study (Campbell et al., 2011) found that late peri-menopausal women (women in the transitional period just before entering the menopause) and post menopausal women, compared with early menopausal women and pre-menopausal women, showed increased EEG beta power during sleep (both REM and NREM sleep).

'Beta power' during sleep can be interpreted as evidence of enhanced arousal, potentially leading to the subjective impression of being awake when, by conventional scoring methods, we are considered categorically asleep. In addition, subjective reports of sleep quality were also found to be reduced over the menopausal transition.

Ongoing work is beginning to assess what treatments may be effective for sleep disturbance in menopausal women; with recent controlled studies looking at the effects of hormone replacement therapy (HRT), anti-depressants, hypnotic sleeping pills, valerian, and non-pharmacological interventions, like yoga, on measures of sleep quality.